Provider Demographics
NPI:1356094049
Name:WADE, NATASHA (DNP-FNP)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 VIA AMALFI
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2852
Mailing Address - Country:US
Mailing Address - Phone:940-366-9989
Mailing Address - Fax:
Practice Address - Street 1:1925 W JOHN CARPENTER FWY
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3224
Practice Address - Country:US
Practice Address - Phone:972-292-7158
Practice Address - Fax:877-292-2247
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily